Articles: adult.
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Curr Opin Anaesthesiol · Jun 2002
Aspiration in pediatric anesthesia: is there a higher incidence compared with adults?
Recent data in both adults and children have suggested that the incidence and severity of the pulmonary aspiration of gastric contents has declined. Previous studies have indicated that aspiration is more common in children than in adults. This review will examine the available data to compare the incidence and severity of aspiration in adults and children. ⋯ Based on the available data, aspiration appears to be slightly more common in children than in adults. The difference, however, is less than that previously reported. Morbidity associated with aspiration is rare in all age groups. This is especially true for children.
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Rev Bras Anestesiol · Apr 2002
Influence of dexmedetomidine upon sevoflurane end-expiratory concentration. Evaluation by bispectral index, suppression rate and electroencephalographic power spectral analysis.
Dexmedetomidine, an alpha2-adrenergic agonist, has been described as being able to decrease the demand for both venous and inhalational agents. This study aimed at evaluating the influence of Dexmedetomidine upon sevoflurane end-expiratory concentration (EC) with monitoring the depth of anesthesia. ⋯ Dexmedetomidine was effective in decreasing sevoflurane end-expiratory concentration while maintaining hemodynamic stability without impairing time for hospital discharge, in addition to promoting an earlier emergence.
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Internal infusion pumps are increasingly used as a safe method to deliver drugs in adult patients. However, a formal contraindication of this mode of therapy is the presence of a imbalance between the pump volume and the size of the abdominal wall as occurs in pediatric populations. We describe a method of implantation of an intrathecal infusion pump for baclofen therapy in a 10-year-old patient with cerebral palsy. ⋯ After three sessions, a pocket similar in size to an internal infusion pump was obtained. The result was a pump pocket with soft shaping and no edges that would not generate pressure sores or tissue tension after the pump insertion. This method could extend the use of internal infusion pumps in pediatric populations.
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Adv Health Sci Educ Theory Pract · Jan 2002
ReviewAndragogy and medical education: are medical students internally motivated to learn?
Andragogy - the study of adult education - has been endorsed by many medical educators throughout North America. There remains, however, considerable controversy as to the validity and utility of adult education principles as espoused by the field's founder, Malcolm Knowles. Whatever the utility of andragogic doctrine in general education settings, there is reason to doubt its wholesale applicability to the training of medical professionals. ⋯ The validity of this hypothesis in medical education is examined, and it is demonstrated that medical students' internal and external motivation are context-dependent, not easily distinguishable, and interrelate with one another in complex ways. Furthermore, the psychological motivation for medical student learning is determined by a variety of factors that range from internal to external, unconscious to conscious, and individual to societal. The andragogic hypothesis of increased internal motivation to learn on the part of adults in general, and medical trainees in particular, is rejected as simplistic, misleading, and counterproductive to developing a greater understanding of the forces that drive medical students to learn.
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Journal of anesthesia · Jan 2002
Randomized Controlled Trial Clinical TrialComparison of heart rate changes after neostigmine-atropine administration during recovery from propofol-N2O and isoflurane-N2O anesthesia.
Propofol augments the reduction of heart rate (HR) in combination with cholinergic agents and attenuates the HR response to atropine. We examined whether propofol anesthesia was associated with an increased incidence and extent of bradycardia after neostigmine-atropine administration compared with the effects of isoflurane anesthesia. ⋯ We conclude that propofol anesthesia attenuates the initial increases in HR, enhances the subsequent decreases in HR, and increases the incidence of bradycardia after neostigmine-atropine injections compared with the effects of isoflurane anesthesia.